Meter Swap ' Request Number: 15269
Public Works Division
Service Request
Problem Address: 6963 Hickory Circle Requested By: Kyle Larson
Department: WA'IER Address: No address p�ovided
Problem/Issue: INSTALL AMR ME1ER Pbone Number: 651-503-4156
Schednled ate: 2017-OS-15 � Schedoled 1lme: 08:00:00
S'
ACITON NEEDED:
Created by: Beth Kondrick 1l�te Crca�ed: 2017-OS-10
A ON TAI�N•
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Status: In Progress Submitter Has Been r.
Contxcted
Date Compteted: Completed by:
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City of Fridley O
Water Detpyartment � � � ��
6431 Universi Avenue NE � �
Fridley,MN 55432
763-572-3566
��We hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. i understand that the property owner is liable for the water line from the main to the premise and all i�rterior
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any dam�ges that may ocwr while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. in understand 1 am atso required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter)
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Name:_t`^� 4� ���v �, Address b �2- (1� 1(
Phone Number �� �r +.� V J�"i��te � � �� ��
Sig�ature Witness Signature �
OLD METER# � I � I �J � � ',
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OLD RFADING � � � �� Q ����+ t I " _��Li�
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NEW METER# �t���1�I ' , '
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NEW READING � i
ERT# I � � �
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FRIDLEY CITY CODE
CHAPTER 402.WA7ER,STORM WATER AND SANITARY S�1NER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,�.156,1191)
402.5 PERMIT FEE !�
Prior to constructing o�repair of any water of sewer line connecting the existing municipal system and�rry house or building for which the
appiication is made,the owner or contractor shall be required to obtain a permit for such connedion,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall�be notified. It sha0 be untawful to wver
any connecting line untit an inspection has been made and such connection and the work incident therelto has been approved by the City as a
proper and suitable connedion.
402.06 REPpIRS AND MAINTENANCE 70 CONNECTION '
After the initial connection has been made to the water senrice curb stop box or the sewer lead at the property line or a water se�lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such prlemises shall be liable for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to t�he premises. ff the property owner
requests maintenance seroice or repairs be performed by the City,the property owner shall be charged for the oosts of the maiMenance and/or
repairs,including necessary street repairs at a rate set annually by an administratFve polky. !t shall be the responsibility of the applicar�t,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will et�sure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
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